Need to No – Giving Too Much

One of my favorite things about patient advocates and navigators is that they are very generous, kind and giving people. They figure out what needs to be done, and they step up to the plate to do it.

But one of my frustrations with patient advocates is that some are too generous, too kind, too giving. Too many have never learned where to draw limits, how to assess when they’ve taken on too much, or are in danger of taking on too much. They just don’t know how or when they “need to (say) no.”

Conversations with two APHA members remind me of this. And it’s worth sharing with you because it may give you the kick in the backside needed to learn to say no when you know you should. Sometime before you begin dropping all those balls you’re juggling.

One case is an advocate who I will call Molly. (We have no members named Molly, so don’t try to figure out who I’m talking about!)? She lamented the fact that she just didn’t have enough work, and was worried about keeping her business afloat – yet – she told me how busy she was with clients. I finally figured out that all those clients were people she was helping for free. They needed help, they could not afford to pay her, so she just began helping them anyway.

How very generous! Remarkably generous, really. And I applaud her for that – except – in effect, she was volunteering her way right out of business. All her time was being spent helping those folks for free, instead of doing marketing, making phone calls, drumming up some speaking opportunities – tasks that could help bring in paying business.

Not to mention the level of stress? (and loss of sleep) when we are not only overworked, but worried that business isn’t going well.

“But,” you say. “Those people need help too!” And I agree. But there needs to be a point where you realize that if you spend your time working for free, and don’t stick to building your business, you will go out of business. At that point, you can’t help anyone all. No one. Not on a paid basis OR on a volunteer basis, because you will have to go out and get a job that will make up the difference. It’s not worth it.

The solution?

I most certainly understand wanting to do help those who need it, perhaps gaining experience even if there is no pay check…. but when those opportunities arise, ask yourself if working for that one person will make a dent in your possibility of working for many. THEN decide if it’s worth it. Maybe it will be! But do yourself a favor, and learn to say, “I’m sorry, I can’t help you. But here are some resources so you may possibly be able to help yourself.”

Then go find the clients who can help you keep your business afloat.

The second circumstance was different, but had a similar outcome. This advocate, who I’ll call Daniel (no, we don’t have a member member named Daniel either) was asked to serve in a volunteer capacity to help develop some health policy in the state he lives in. He was told it would be part time, limited hours. But, like so many of these “part time” things do – it expanded to simply consume every hour of the day, every day. The people he was working with had high expectations of what he should deliver, but no understanding of the toll that was taking.

The problem is that it’s flattering to be asked to be on these boards or to rub elbows with people who are important. And of course, networking is always a great way for clients to find you. But at some point, the line must be drawn when it begins to impinge on your ability to do your work – the patient advocating and navigating that represents what your goals and hopes were. Health policy is one thing and yes, it affects many people. But if you lost your business, then no one will want you working on health policy (or a caregiver’s council or a hospital foundation – whatever it may be) anymore either!

Decisions…. decisions…..

Learning to Say No

Saying “no” does not have to be that difficult, and when done properly, will be respected. Develop a “need-to-no” plan for yourself, rehearse it, and when it’s time to pull it out, it will be easier to follow through.

Some examples:

“I do wish I could help you, but my plate is already way too full. I’d be afraid of dropping the ball….” or

“Ordinarily I’d jump at the chance to help you out, but I’m sure you’ll understand that I’m already so overextended….” or

“My work requires me to be on call for my patients. I can’t agree to help you because I never know when I’ll be called away…. I’m sure you understand.”

…. you get the drift. Something that acknowledges the request, confirms that you wish you could help, but makes it clear that you can’t.

Yes – sometimes we “need to no.” No one needs to give you permission to no. It’s your time, your business, and your right.

You’ll know when it’s appropriate. Just do it!


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